Ask women living with HIV what's needed to achieve safe pregnancies in serodifferent relationships

Motherhood and decision-making among women living with HIV in developed countries: a systematic review with qualitative research synthesis

“…Misinformation and prejudice continue in clinical practice [ 24 ] as WLH do not feel supported by their clinicians. They report discrimination and stigma in some cases [ 25 ]; with the resulting fear and anxiety negatively impacting their relationships with clinicians and their confidence in the health system [ 26 ]. WLH require comprehensive evidence-based care to safely fulfill their decisions about motherhood, whether this involves preventing [ 9 ] or safely advancing a pregnancy [ 27 ].…”

Supporting people living with HIV in serodiscordant partnerships to attempt a desired pregnancy by integrating sexual and reproductive health and HIV interventions

“…The commentary by Orza et al [13], from the perspective of women living with HIV, reports that few women feel empowered to have “self-determination regarding their sexual and reproductive health and rights”. Similarly, when presenting the perspectives of men living with HIV who desire children, Fransen-dos Santo and Guarinieri [16] state, “Public health reasoning or simple stigma (experienced and internal) had greater weight than principles of human rights and gender equity, making it especially challenging for men living with HIV to even consider accessing sexual and reproductive health services.…”

“…An example is the commonly used acronym, which can refer to antiretroviral treatment for HIV, and also assisted reproductive technologies. Terms, and positive language in particular, also matter to clients, as presented by women living with HIV in the article by Orza et al [ 13 , 14 ]; as an example, some women who are in a relationship within which only one partner has been diagnosed as HIV positive prefer to be defined within a “serodifferent” partnership rather than a partnership described as “serodiscordant”.…”

“…Saleem et al [ 15 ] describe a social ecological framework to characterize the interrelated opportunities at multiple levels that need to be implemented in order to ensure a rights-based approach to the integration of sexual reproductive health and rights and HIV services for people in serodiscordant relationships who desire pregnancy. The commentary by Orza et al [ 13 ], from the perspective of women living with HIV, reports that few women feel empowered to have “self-determination regarding their sexual and reproductive health and rights”. Similarly, when presenting the perspectives of men living with HIV who desire children, Fransen-dos Santo and Guarinieri [ 16 ] state, “Public health reasoning or simple stigma (experienced and internal) had greater weight than principles of human rights and gender equity, making it especially challenging for men living with HIV to even consider accessing sexual and reproductive health services.…”

HIV‐affected couples and individuals who desire children should be offered options for safer conception

“…However, given the evidence that HIV-affected couples can achieve pregnancy through condomless sex with zero or near-zero risk of HIV transmission [ 2 ], we disagree with the authors’ assertion that assisted reproductive technologies should be the treatment of choice over other safer conception strategies. Women and men living with HIV desire counselling on a range of safer conception options; offering this counselling will allow individuals to meet their reproductive goals while minimizing HIV transmission [ 3 , 4 ].…”